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Déjà vu in France during the 19th century: A conceptual history
Vu in France During the 19th Century: A Conceptual History G.E. Berrios The feeling of d~j~ vu features as prominently in the creative as in the clinical literature. However, its meaning and mechanisms remain unclear, and it is posited here that this has partially resulted from the way in which this symptom was originally conceptualized. During the late 19th century, medical opinion seemed agreed that d6j~ vu was a disorder of memory (a paramnesia). However, its study was obfuscated by an overemphasis on its secondary features (e.g., "feeling of conviction," "fleetingness") and by "'parapsychologi-
cal" interpretations. Around the turn of the century, the problem was compounded by the development of narrow models of memory (inspired by association psychology) that left no room for the descriptive complexities of d6j~ vu. Consequently, it soon became land has remained) a "symptom without a psychological function." French psychological writers played a crucial role in the conceptualization of d(~j~ vu and this report presents a detailed history of their contribution.
H E R E HAS B E E N renewed interest of late in the d6j& vu experience thanks to the excellent studies reported by Sno et al. 1-3 Although this group has covered well the general European history of the phenomenon, its origin in French psychiatry remains unclear, as does its association with the history of memory disorders and with the general history of cognition during the 19th century. This report addresses specifically these two areas. As Sno and Lindszen 1 have correctly suggested, descriptions redolent of d6j& vu can be found in earlier periods. 4 However, the phenomenon was only conceptualized as a "memory problem" during the 19th century. For example, Sir Walter Scott called it "sentiment of preexistence," and Wigan defined it as a "sudden feeling, as if the scene we have just witnessed (although, from the very nature of things it could never have been seen before) had been present to our eyes on a former occasion, when the very same speakers, seated in the very same positions, uttered the same sentiments, in the same words--the postures, the expression of countenance, the gestures, the tone of voice, all seem to be remembered, and to be now attracting attention for the second time. Never it is supposed to be the third time . . . . I believe the explanation to be this: only one brain has been used in the immediate preceding part of the scene--the other brain has been asleep, or in an analogous state nearly approaching it. When the attention of both brains is roused to the topic, there is the same vague consciousness that the ideas have passed through the mind before, which takes place on re-perusing the page we had read while thinking on some other
subject. The ideas have passed through the mind before, and as there was not sufficient consciousness to fix them in the memory without a renewal, we have no means of knowing the length of time that had elapsed between the faint impression received by the single brain, and the distinct impression received by the double brain. It may seem to have been many years. ''5 A year later, and independently from Wigan, the Austrian Feuchtersleben described the phenomenon of "phantasms of memory": "for instance, when a person feels as if a situation in which he actually finds himself had already existed at some former time . . . . ,,6 Hughlings Jackson also wrote on the "sensation of reminiscence," one of his earliest notes being in 1876 when he suggested that such feelings, seen in epileptic patients with "intellectual aura," were "not uncommon in healthy people. ''7 At this time Jackson believed that Wigan's model of "double consciousness" was an "accurate account." In 1888, he again wrote on sensations of reminiscence when referring to a medical colleague who, under the pseudonym of "Qu~erens" (pp. 389-390), 7 had reported his own temporal lobe epilepsy. To illustrate his feeling of reminiscence, Qu~erens quoted from David Copperfield: "We have all some experi-
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Copyright © 1995by W.B. Saunders Company
From the Department of Psychiatry, University of Cambridge, Cambridge, UK. Address reprint requests to G.E. Berrios, M.D., Department of Psychiatry, University of Cambridge, Addenbrooke's Hospital (Box 189), Hills Road, Cambridge, UK CB2 2QQ. Copyright © 1995 by W.B. Saunders Company 0010-440X/95 / 3602-0004503.O0/ 0
ComprehensivePsychiatry, Vol. 36, No. 2 (March/April), 1995: pp 123-129
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ence of a feeling which comes over us occasionally of what we are saying and doing having been said or done before, in a remote time---of our having been surrounded, dim ages ago, by the same faces, objects, and circumstances---of our knowing perfectly what will be said next, as if we suddenly remember it." In 1899, Jackson repeated his view that this double consciousness or "mental diplopia" was an accompaniment of the "dreamy state" (pp. 467-468). 7 Soon after this, French psychiatrists took over analysis of the phenomenon. To understand their views, it is useful to have an idea of the history of memory and its disorders during this period. HISTORY OF MEMORY DISORDERS
In general, historical analysis of the disorders of memory is important for various reasons: first, models of memory not dissimilar to current ones have been described in the past8.9; second, because these models emerged from clinical observation, their structure reflects the amnestic vicissitudes of some famous patients; and third, historical exploration 1° might help to resolve "boundary" disputes, for example, whether memory is actually impaired in clinical states such as depressive pseudodementia, 11 schizophrenia, 12,13fugues,14confabulation,15and d6jh vu. 16 By the 1890s, disorders of memory had become a favored topic of research, and in this trend Ribot played a central role. However, from the vantage point of the present, his oft-quoted book, Les Maladies de la M~moire, is not easy to understand: Ribot's model of memory owes more to early 19th century notions than to those developed by his contemporary, Ebbinghaus, who based his ideas on an associationistic model. 17,18 Ribot divided the disorders of memory into amnesia, partial amnesia, and the exaltations of memory. He conceived of "diseases of memory as morbid psychical states" that could be "limited to a single category of recollections" or affect "the entire memory in all its forms. ''19,2° Whether partial or general, amnesia could be temporary, periodical, progressive, and congenital. For example, epilepsy might cause a typical form of temporary amnesia; likewise, the phenomenon of double consciousness21,22was his best example of periodic amnesia; senile dementia and cerebral hemor-
rhage were the main causes of progressive forms of amnesia; and finally, congenital amnesias were seen in idiots and cretins. Ribot was a philosopher-psychologist, and his footing is not always safe when dealing with medical facts. Jules Falret, on the other hand, was an alienist, and in his work on Amndsie, 23 first published in 1865 and written from a medical viewpoint, he offered one of the best accounts of the disorder at the middle of the century. The main conclusion to be drawn from his work is that by the 1860s, the concept of "amnesia" carried a descriptive emphasis and included no assumptions with regard to etiology or duration. Although Falret did distinguish between physical and psychological causes and between general and partial forms of amnesia, his work--like that of his contemporary, the English Forbes Winslow24 (see chapters xxiii to xvii of his book)--can be considered as a rich collection of clinical observations in which the modern neuropsychiatrist can find antecedents for almost all recently described syndromes including transient global amnesia, acute intoxication with anticholinergics, senile dementia, and state-dependent learning. THE CONCEPT OF "PARAMNESlA"
The terms "paramnesia" and "delusion of memory" are now rarely used in medical practice to refer to memories of (mainly) autobiographical events that have not taken place. 25 D~lire de m~moire, nonetheless, lingered on in French neuropsychiatry up to World War II when, for example, Jean Delay still used it to refer to confabulation, ecmnesia, or hallucination of the past, and paramnesia or false recognition.26 It was otherwise between 1880 and World War I, when the paramnesias attracted marked academic interest. To 19th-century alienists, these symptoms were distinct enough and universally considered to reflect a disorder of memory. However, subsequent changes in the models of memory (and not empirical research) led to the belief that at best, these clinical phenomena are "delusions,''27 and at worst, "symptoms without function"; this latter notion involved a violation of the principle on which 19th-century descriptive psychopathology (or psychiatric semiology) was founded, namely that each symptom had to
HISTORY OF DEJA VU
correspond to the dysfunction of a recognized mental faculty.28,29 By the time Emil Kraepelin published his classic articles on the paramnesias--which he called "false reminiscences"3°---the theme had already been debated by others in the literature, for example, by James Sully in a chapter of his book on illusions of memory.31 Indeed, since the time of St Augustine, and contemporarily since H. Charlton Bastian and H. Emminghaus,8 it had been suggested that such experiences encourage belief in metempsychosis (i.e., "transmigration of the soul") and reincarnation. 32,33 Terms such as phantasms of memory, sentiments of pre-existence, pseudo-reminiscences, paramnesias, fallacies of memory, and eventually d6j~ vu were successively used to refer to overlapping clinical phenomena. During the final years of the 19th century, and as more attention was paid to clinical detail, further qualifications ensued: for example, paramnesias were said to occur in clinical states such as insanity, confusion, and delirium, and also in dreaming, clear consciousness, and normality. They were said to be either fleeting or persistent, spontaneous, and vivid, or sometimes only recollected with the help of hypnosis. It was believed that the recalled experience could have taken place either within the life span of the individual or even before birth. This latter view may explain the interest of psychic researchers in the paramnesias. Such multiplicity of names and views reflects the staggered evolution of the notions of consciousness and memory. James Sully, for example, divided "false recollections" into (1) false events (when the recollected event had not, in fact, taken place), (2) formal distortions of real events, and (3) temporal dislocations of real events. This classification was, in fact, modeled on an old division of the disorders of perception (namely into hallucinations, illusions, and sensory distortions). 31 Influenced by Sander's report on Erinnerungstiiuschungen (where the great German alienist, still working in Berlin, reviewed a wide number of phenomena including that of"the doubles") 34 and by James Sully, Kraepelin focused on one of Sully's clinical groupings, namely false recollections or true hallucinations of memory. He called them "pseudo-reminiscences" and subdi-
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vided them into (1) simple, (2) "evoked," and (3) "identified.''3° The first group included spontaneous images that appear in the subject's mind already accompanied by a "feeling of recollection"; the second included real perceptions that evoke in the individual the feeling that he has experienced them before (what is now called d6j~ vu); and the third included perceptions that evoke the experience of being exact copies of earlier ones. Although it is not always possible to differentiate between types 2 and 3, Kraepelin's classification suggested an analogy between simple pseudo-reminiscences and delusions and evoked ones and illusions and hallucinations. Kraepelin reported 18 cases, some borrowed from contemporary psychiatrists such as von Gudden and Forel. THE REVUE PHILOSOPHIQUE DEBATE
Interest in the paramnesias peaked in the middle 1890s. This is well illustrated by a debate in the Revue Philosophique. (This journal was founded in 1876 by Ribot, who remained its editor until his death in 1916; it published seminal reports in the history of psychopathology.) Andr6 Lalande (a philosopher) started the exchanges with a report summarizing the views of Sully, Ribot, Kraepelin, and the American W.H. Burnham. 8 He then suggested that (1) the feeling of false recognition was "instantaneous" and "complete" (i.e., the subject did not say that the situation was similar, but that it was exactly the same), (2) the experience was often accompanied by a feeling of anxiety or apprehension, and (3) the subject often believed that he could predict what was to follow. Lalande believed the phenomenon was not necessarily "pathological" and that (regardless of education) it was experienced by approximately 30 percent of the population. 35 He listed various explanatory hypotheses, ruled out reincarnation, and opted for a version of the "double representation" view. L. Dugas followed with a report criticizing Lalande's but admitting that "he had no theory of his own. ''36 He believed that the concept of false memory had to be distinguished from the "impression of d6jfi vu." This latter usage actually predates Arnaud's (see below). Dugas indicated that the term d6jfi vu had first been used by Verlaine (1844-1896) in his poem KalOido-
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scope, and reported that an acquaintance of his, who also experienced the symptom, had told him that Loti (the pen name of Julien Viaud, 1850-1923) described a similar experience on seeing the sea for the first time (to be found in Loti's Roman d'un Enfant). Dugas believed that d6jh vu was more common among young people (between ages 20 and 30) and agreed with Lalande that it was not necessarily pathological (because those reporting it often were balanced and intelligent people). Nonetheless, he suggested that it might reflect an hereditary taint. Dugas differentiated between false memories with and without a feeling of premonition (pressentiment). The former, which he called simple or incomplete, he explained as resulting from two perceptions separated in time by a short period or "absence"; and to explain the intensity of the first perception he considered it an "apperception." This concept, popular at the time, was defined as that part of attention that involved interaction between the presentation of the object attended to, the total preceding conscious content, and the preformed mental dispositions. It had been introduced by Leibnitz and developed by Kant and Herbart. 37 Dugas rejected Lalande's view that telepathy was at all involved in d6jfi vu, and suggested that it might be a special case of "double personality." DOdoublement de la personnalit~ was a popular notion in late 19th-century France: then, as now, it helped to explain clinical situations in which the subject presented contradictory forms of behavior. 38 The next to participate in the debate was Jacques Le Lorrain, who believed that Lalande's diagnostic criteria required tightening, and predicted that if this was accomplished, the phenomenon would become rare. 39 Next was Paul Lapie proposing a "coincidence" theory, according to which the imagination of man created situations that were then deposited as memories and that, on occasion, coincided with real-life perceptions. 4° Finally, the fray was joined by van Biervliet, 41,42who supported the double-representation view, and by the Italian Vignoli, 43who proposed a threefold explanation for d6j~tvu that included dream work, the speed of psychological processes, and disordered imagination. The Revue Philosophique debate was not satisfactorily resolved. However, it showed the
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difficulties involved in translating a sui generis experience into either psychological or neurophysiological discourse. In the event, those involved in the debate had to invent a form of inchoate "cognitive psychology. ''44 THE DEBATE AT THE SOCIETE
MEDICO-PSYCHOLOGIQUE However, the earliest clinical usage of the term d6jh vu in a fully modern sense remains unclear. This writer would suggest that it tentatively occurred in 1894 in articles written by Dugas, 36,45 and then definitely in 1896 at the meeting of the Socidt~ M~dico-Psychologique (Paris, France, February 24, 1896). In this historical session, Arnaud stated: "I believe that it would be better to abandon the words false memory and paramnesia that have the double inconvenient of being vague and inexact as the phenomenon in question may not be associated with memory at all. So to keep things clear and make no theoretical assumptions, I suggest illusion of d~jgz vu ...,,46 (my italics). Arnaud then chronicled the history of the concept, mentioning writers such as Wigan, Maudsley, Sully, Jensen, Sander, Pick, Anjel, Forel, Kraepelin, Ribot, Lalande, Dugas, and Sollier. He attacked the prevalent view that the phenomenon was "common in the normal": "It is likely that the frequency of the illusion of d6jfi vu has been exaggerated for it has been confused with analogous states such as obscure memories, vague and remote recollections, etc. The true d6jh vu has two central features: its intensity, which often borders on conviction, and the feeling of an identity between the subjective experience and that assumed to be recollected . . . " (p. 456) 46 (my italics). Arnaud distinguished a mild form and a severe form of the disorder, the latter being almost delusional in nature and mostly pathological. Then Arnaud reported the case of Louis, a 34-year-old graduate from Saint Cyr (the French military academy) who had a family history of psychiatric illness (mother was said to be "nervous") and had experienced d6jh vu as a child. After developing cerebral malaria in Tonkin, he returned to France in 1891, when he was found to be suffering from anterograde and retrograde amnesia. He improved after 7 months, but by January 1893 he began to report d6jfi vu experi-
HISTORY OF DI~J,&, VU
ences: for example, he claimed he could recognize newspaper articles that he claimed he "had written" himself. At the marriage of his brother, he insisted that he had attended the same ceremony a year before. After failing in his attempt to marry (through opposition from the bride's parents), he became aggressive and developed ideas of persecution and fears that his headaches were being caused by drugs given him. When receiving hydrotherapy, he had the feeling that he had visited the same establishment the year before. In July 1894, he was admitted to the Hospital of Vanves, where he "recognized" places, the staff, and even their words and gestures. On meeting Dr. Arnaud, he said: "You know me doctor. You also welcomed me last year, at the same time of the day, and in this same room. You asked me the same questions, and I gave you the same answers" (p. 458), 46 and he said the same to the great Jules Falret (then head of the establishment). At no time did the patient exhibit hallucinations; he kept insisting that his current existence was a repetition of the previous year's, and believed he could recognize great public events that occurred in France between 1894 and 1895 (such as the election of F61ix Faure and the death of Pasteur). Retrograde and anterograde memory defect remained present throughout. Arnaud asked pointed questions about the nature and duration of the phenomenon and about the interval between the "original perception" and the actual experience of d6jh vu. He criticized available theories such as the double brain, metempsychosis, telepathy, delayed perception, parallel hallucination, and successive perceptions of the same event separated by a moment of distraction. He concluded that d6j~ vu was a current experience projected onto the past. During the ensuing debate, Pierre Janet claimed that d6jh vu was a perceptual rather than a memory disorder, and Paul Garnier defended the opposite view. BERNARD-LEROY AND THE BEGINNING OF EMPIRICAL ANALYSIS
The final stage in the 19th-century history of d6j~ vu is marked by Bernard-Leroy's surveyJ 6 This researcher believed that because the phenomenon was subjective and there were marked interindividual differences, single-case report-
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ing was an inappropriate method of study. He conducted a survey based on a 36-question instrument that was widely circularized (with the help of the Revue of Hypnotisme and the
Proceedings of the Medico-Legal Society of New York). The instrument included complex questions, such as: "Have you ever experienced the feeling of so-called 'false recognition' alluded to by Dickens in the following passage... ?" Or question 15: "If you have experienced this, were you under the influence of alcohol, opium, morphine, ether, chloroform (please specify the dose)?" Or question 35: "Do you suffer from attacks, obsessions, phobias, panics, absences, convulsive tics or other neurological disorders?" It is no wonder, therefore, that respondents were only recruited from the educated classes (e.g., college students, philosophers, priests, medical doctors, psychologists, and writers) and included great men such as Paul Adam, Emile Zola, Paul Borget, Fernand Gregh, Jules Lemaitre, and E. Boirac. Leroy received 67 replies, but based his report on only 49, to which he added 38 cases culled from the literature. This method of data collection was relatively new at the time and is likely to have been inspired by the "International Census of Waking Hallucinations in the Sane. ''47 The idea had been first suggested at the International Congress of Psychology held in Paris in 1889. The ensuing survey, completed in 1892, was followed by another conducted by the Cambridge Society for Psychic Research. 48 Leroy concluded that heterogeneous phenomena were involved and that no one hypothesis could account for them all. THE AFTERMATH
Early in the 20th century, the Dutch psychologist Gerardus Hymans conducted two prospective surveys improving on Leroy's investigations. 3 Since then, little new had been said about ddj~ vu until studies were reported by Sno. In 1931, Berndt-Larsson suggested, once again that a normal form and a pathological form of d6j~ vu should be distinguished. The former type, which was transient and caused little emotional upheaval, resulted from a disturbance of perception akin to illusion; the latter,
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persistent and leading to perplexity and cognitive disorganization, constituted a veritable delusional disorder. 49 D6jh vu was thus considered analogous to the so-called misidentification syndromes (e.g., intermetamorphosis 5° and Fr6goli syndrome 51,52) in that both entailed delusional misrecognitions: in d6jh vu, of situations, in the others, of people. 53 Likewise, the jamais vu phenomenon was matched with the Capgras syndrome 54 in that both seemed to result from a pathological change in a putative feeling of "familiarity.''55
D6jh vu is nowadays rarely mentioned in studies on the experimental psychology of memory. 56-59Neuropsychiatric textbooks call it a "feeling" or an "illusion" and give no guidance as to what its relationship is to memory function. 6° Some French researchers have treated d6j~ vu as a disorder of perception61; others, as a "paroxysmic alteration of consciousness"62; and yet others, as in the case of Penfield, called it the "illusion of familiarity" and regard it as associated with the temporal lobe. 63 The debate continues.
REFERENCES 1. Sno H, Lindszen DH. The d6jh vu experience. Am J Psychiatry 1990;147:1587-1595. 2. Sno H, Lindszen DH, de Jonghe F. Art imitates life: d6jh vu experiences in prose and poetry. Br J Psychiatry 1992;160:511-518. 3. Sno H, Draaisma D. An early Dutch study of d6j~t vu experiences. Psychol Med 1993;23:17-26. 4. Hunter R, McAlpine I. Three Hundred Years of Psychiatry 1535-1860. Oxford, UK: Oxford University Press, 1963. 5. Wigan AL. The Duality of the Mind. London, UK: Longman, Brown, Green, and Longmans, 1844:84-85. 6. Feuchtersleben E. The Principles of Medical Psychology. London, UK: Sydenham Society, 1847. 7. Taylor J. Selected Writings of J.H. Jackson. Vol. 1. London, UK: Hodder & Stoughton, 1931. 8. Burnham WH. Memory, historically and experimentally considered. Am J Psychol 1888-89;2:39-90, 225-270, 431-464, 568-622. 9. Levin HS, Peters BH, Hulkonen DA. Early concepts of anterograde and retrograde amnesia. Cortex 1983;19:427440. 10. Edgell B. Theories of Memory. Oxford, UK: Clarendon, 1924. 11. Bulbena A, Berrios GE. Pseudodementia: facts and figures. Br J Psychiatry 1986;148:87-94. 12. Rund BR. Cognitive disturbances in schizophrenics: what are they, and what is their origin? Acta Psychiatr Scand 1988;77:113-123. 13. Kirkpatrick B, Johnson M, McGuire K, Fletcher RH. Confounding and the dementia of schizophrenia. Psychiatry Res 1986;19:225-231. 14. Benon R, Froissart P. Les fugues en pathologie mentale. J Psychol Norm Pathol 1909;6:293-330. 15. Berrios GE. Presbyophrenia: the rise and fall of a concept. Psychol Med 1986;16:267-275. 16. Bernard-Leroy E. L'Illusion de fausse reconnaissance. Contribution a I'etude des conditions psychologiques de la reconnaissance des souvenirs. France: Paris, Alcan, 1898. 17. Caparr6s A. H. Ebbinghaus, un funcionalista investigador tipo dominio. Barcelona, Spain: Edicions Universitat de Barcelona, 1986. 18. Ebbinghaus H. lJber das Ged~ichtnis. Untersuchun-
gen zur experimentellen Psychologie. Leipzig, Germany: Duncker und Humblot, 1885. 19. Ribot T. Diseases of Memory [translation of 1881 first French edition]. London, UK: Kegan Paul, Trench & Co, 1882. 20. Ribot T. Les d6sordres g6n6raux de la m6moire. Rev Philosoph 1880;10:181-214, 485-516. 21. Bourgeois M, Geraud M. Eugene Azam (1822-1899). Ann Med Psychol (Paris) 1990;148:709-717. 22. Azam E. Amn6sie P6riodique. Ann Med Psychol (Paris) 1876;34:5-35. 23. Falret J. Amn6sie. In: Dictionnaire Encyclop6dique des Sciences M6dicales. Vol. 3. Paris, France: Asselin & Masson, 1865:725-742. 24. Winslow F. On Obscure Diseases of the Brain and Disorders of the Mind. Ed. 2. London, UK: JW Davies, 1861. 25. Ey H. Les Troubles de la M6moire. t~tude No 9. In: l~tudes Psychiatriques. Aspects S6m6iologiques. Paris, France: Descl6e de Brouwer, 1950:9-68. 26. Delay J. Les maladies de la M6moire. Paris, France: Presses Universitaires de France, 1942. 27. Buchanan A. Delusional memories: first rank symptoms? Br J Psychiatry 1991;159:472-474. 28. Berrios GE. Descriptive psychopathology. Conceptual and historical aspects. Psychol Med 1984;14:303-313. 29. Berrios GE. Historical background to abnormal psychology. In: Miller E, Cooper PJ (eds): Adult Abnormal Psychology. Edinburgh, UK: Churchill Livingstone, 1988:2651. 30. Kraepelin E. l~Iber Erinnerungsf/ilschungen. Arch Psychiatr Nervenkr 1886-87;17:830-843, 18:199-239, 395436. 31. Sully J. Illusions. A Psychological Study. Ed. 4. London, UK: Kegan Paul, Trench, Trubner & Co, 1894. 32. Bonin WF. Lexicon der Parapsychologie und ihrer Grenzgebiete. Bern, Switzerland: Scherz, 1976. 33. Inardi M. Historia de la Parapsicologla. Guayaquil, Ecuador: Ariel, 1976. 34. Sander W. Uber Erinnerungst/iuschungen. Arch Psychiatr Nervenkr 1874;4:244-253. 35. Lalande A. Des Paramn6sies. Rev Philosoph 1893;36: 485-487.
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36. Dugas L. Observations sur la Fausse M6moire. Rev Philosoph 1894;37:34-45. 37. Lange K. Apperception. Boston, MA: Health, 1900. 38. Merskey H. The manufacture of personalities. The production of multiple personality disorder. Br J Psychiatry 1992;160:327-340. 39. Le Lorrain J. A propos de la paramn6sie. Rev Philosoph 1894;37:208-210. 40. Lapie P. Note sur la Paramn6sie. Rev Philosoph 1894;37:351-352. 41. van Biervliet JJ. Observations et documents sur les paramn6sies. Rev Philosoph 1894;38:47-49. 42. van Biervliet JJ. La M6moire. Paris, France: Doin, 1902:276-304. 43. Soury J. Sulla Paramnesia o false memoria. Nota del prof Tito Vignoli. Rev Philosoph 1894;38:50-51. 44. Adarraga P. E1 marco general de la psicologia cognitiva. In: CastiUa del Pino C, Ruiz-Vargas JM (eds): Aspectos cognitivos de la esquizofrenia. Madrid, Spain: Trotta, 1991:35-56. 45. Dugas L. L'Impression de 'l'enti6rement noveau' et celia de 'd6jh vu.' Rev Philosoph 1894;38:40-46. 46. Arnaud M. Un cas d'illusion de 'd6ja vu' ou de 'false memory.' Ann Med Psychol (Paris), 1896;54:455-471. 47. Parish E. Hallucinations and Illusions. London, UK: Walter Scott, 1897. 48. Gurney E, Myers FWH, Podmore E. Phantasms of the Living. Vol. 2. London, UK: Trubner, 1896. 49. Berndt-Larsson H. 0ber das D6jh vu und andere T/iuschungen des Bekanntheitsgefiihls. Z Gesamte Neurol Psychiatr 1931;133:521-539.
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50. Bick PA. The syndrome of intermetamorphosis. In: Christodoulou GN (ed): The Misidentification syndromes. Basel, Switzerland: Karger, 1986:131-135. 51. Christodoulou GN. Delusional hyper-identification of the Fr6goli type. Acta Psychiatr Scand 1976;54:305-314. 52. Pauw KW. Fr6goli syndrome after cerebral infarction. J Nerv Ment Dis 1987;175:433-438. 53. Markov~i IS, Berrios GE. The delusional misidentification syndromes. Psychopathology 1994;27:136-143. 54. Derombies M. L'illusion de sosies. Paris, France: Th~se de M6dicine, 1935. 55. Critchley EMR. The neurology of familiarity. Behav Neurol 1989;2:195-200. 56. Squires L. Memory and the Brain. Oxford, UK: Oxford University Press, 1987. 57. Parkin AJ. Memory and Amnesia. Oxford, UK: Blackwell, 1987. 58. Mayes AR. Human Organic Memory Disorders. Cambridge, UK: Cambridge University Press, 1988. 59. McCarthy RA, Warrington EK. Cognitive Neuropsychology. San Diego, CA: Academic, 1990. 60. Lishman WA. Organic Psychiatry. Oxford, UK: Blackwell, 1987. 61. H6caen H, Albert ML. Human Neuropsychology. New York, NY: Wiley 1978:155. 62. Paillas JE, Subirana A. S6m6iologie Neuro-Psychiatrique. Rev Oto Neuro Ophtalmol 1950;22:123-218. 63. Mullan S, Penfield W. Illusions of comparative interpretation and emotion. Arch Neurol Psychiatry 1959;81:269284.
cal" interpretations. Around the turn of the century, the problem was compounded by the development of narrow models of memory (inspired by association psychology) that left no room for the descriptive complexities of d6j~ vu. Consequently, it soon became land has remained) a "symptom without a psychological function." French psychological writers played a crucial role in the conceptualization of d(~j~ vu and this report presents a detailed history of their contribution.
H E R E HAS B E E N renewed interest of late in the d6j& vu experience thanks to the excellent studies reported by Sno et al. 1-3 Although this group has covered well the general European history of the phenomenon, its origin in French psychiatry remains unclear, as does its association with the history of memory disorders and with the general history of cognition during the 19th century. This report addresses specifically these two areas. As Sno and Lindszen 1 have correctly suggested, descriptions redolent of d6j& vu can be found in earlier periods. 4 However, the phenomenon was only conceptualized as a "memory problem" during the 19th century. For example, Sir Walter Scott called it "sentiment of preexistence," and Wigan defined it as a "sudden feeling, as if the scene we have just witnessed (although, from the very nature of things it could never have been seen before) had been present to our eyes on a former occasion, when the very same speakers, seated in the very same positions, uttered the same sentiments, in the same words--the postures, the expression of countenance, the gestures, the tone of voice, all seem to be remembered, and to be now attracting attention for the second time. Never it is supposed to be the third time . . . . I believe the explanation to be this: only one brain has been used in the immediate preceding part of the scene--the other brain has been asleep, or in an analogous state nearly approaching it. When the attention of both brains is roused to the topic, there is the same vague consciousness that the ideas have passed through the mind before, which takes place on re-perusing the page we had read while thinking on some other
subject. The ideas have passed through the mind before, and as there was not sufficient consciousness to fix them in the memory without a renewal, we have no means of knowing the length of time that had elapsed between the faint impression received by the single brain, and the distinct impression received by the double brain. It may seem to have been many years. ''5 A year later, and independently from Wigan, the Austrian Feuchtersleben described the phenomenon of "phantasms of memory": "for instance, when a person feels as if a situation in which he actually finds himself had already existed at some former time . . . . ,,6 Hughlings Jackson also wrote on the "sensation of reminiscence," one of his earliest notes being in 1876 when he suggested that such feelings, seen in epileptic patients with "intellectual aura," were "not uncommon in healthy people. ''7 At this time Jackson believed that Wigan's model of "double consciousness" was an "accurate account." In 1888, he again wrote on sensations of reminiscence when referring to a medical colleague who, under the pseudonym of "Qu~erens" (pp. 389-390), 7 had reported his own temporal lobe epilepsy. To illustrate his feeling of reminiscence, Qu~erens quoted from David Copperfield: "We have all some experi-
T
Copyright © 1995by W.B. Saunders Company
From the Department of Psychiatry, University of Cambridge, Cambridge, UK. Address reprint requests to G.E. Berrios, M.D., Department of Psychiatry, University of Cambridge, Addenbrooke's Hospital (Box 189), Hills Road, Cambridge, UK CB2 2QQ. Copyright © 1995 by W.B. Saunders Company 0010-440X/95 / 3602-0004503.O0/ 0
ComprehensivePsychiatry, Vol. 36, No. 2 (March/April), 1995: pp 123-129
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ence of a feeling which comes over us occasionally of what we are saying and doing having been said or done before, in a remote time---of our having been surrounded, dim ages ago, by the same faces, objects, and circumstances---of our knowing perfectly what will be said next, as if we suddenly remember it." In 1899, Jackson repeated his view that this double consciousness or "mental diplopia" was an accompaniment of the "dreamy state" (pp. 467-468). 7 Soon after this, French psychiatrists took over analysis of the phenomenon. To understand their views, it is useful to have an idea of the history of memory and its disorders during this period. HISTORY OF MEMORY DISORDERS
In general, historical analysis of the disorders of memory is important for various reasons: first, models of memory not dissimilar to current ones have been described in the past8.9; second, because these models emerged from clinical observation, their structure reflects the amnestic vicissitudes of some famous patients; and third, historical exploration 1° might help to resolve "boundary" disputes, for example, whether memory is actually impaired in clinical states such as depressive pseudodementia, 11 schizophrenia, 12,13fugues,14confabulation,15and d6jh vu. 16 By the 1890s, disorders of memory had become a favored topic of research, and in this trend Ribot played a central role. However, from the vantage point of the present, his oft-quoted book, Les Maladies de la M~moire, is not easy to understand: Ribot's model of memory owes more to early 19th century notions than to those developed by his contemporary, Ebbinghaus, who based his ideas on an associationistic model. 17,18 Ribot divided the disorders of memory into amnesia, partial amnesia, and the exaltations of memory. He conceived of "diseases of memory as morbid psychical states" that could be "limited to a single category of recollections" or affect "the entire memory in all its forms. ''19,2° Whether partial or general, amnesia could be temporary, periodical, progressive, and congenital. For example, epilepsy might cause a typical form of temporary amnesia; likewise, the phenomenon of double consciousness21,22was his best example of periodic amnesia; senile dementia and cerebral hemor-
rhage were the main causes of progressive forms of amnesia; and finally, congenital amnesias were seen in idiots and cretins. Ribot was a philosopher-psychologist, and his footing is not always safe when dealing with medical facts. Jules Falret, on the other hand, was an alienist, and in his work on Amndsie, 23 first published in 1865 and written from a medical viewpoint, he offered one of the best accounts of the disorder at the middle of the century. The main conclusion to be drawn from his work is that by the 1860s, the concept of "amnesia" carried a descriptive emphasis and included no assumptions with regard to etiology or duration. Although Falret did distinguish between physical and psychological causes and between general and partial forms of amnesia, his work--like that of his contemporary, the English Forbes Winslow24 (see chapters xxiii to xvii of his book)--can be considered as a rich collection of clinical observations in which the modern neuropsychiatrist can find antecedents for almost all recently described syndromes including transient global amnesia, acute intoxication with anticholinergics, senile dementia, and state-dependent learning. THE CONCEPT OF "PARAMNESlA"
The terms "paramnesia" and "delusion of memory" are now rarely used in medical practice to refer to memories of (mainly) autobiographical events that have not taken place. 25 D~lire de m~moire, nonetheless, lingered on in French neuropsychiatry up to World War II when, for example, Jean Delay still used it to refer to confabulation, ecmnesia, or hallucination of the past, and paramnesia or false recognition.26 It was otherwise between 1880 and World War I, when the paramnesias attracted marked academic interest. To 19th-century alienists, these symptoms were distinct enough and universally considered to reflect a disorder of memory. However, subsequent changes in the models of memory (and not empirical research) led to the belief that at best, these clinical phenomena are "delusions,''27 and at worst, "symptoms without function"; this latter notion involved a violation of the principle on which 19th-century descriptive psychopathology (or psychiatric semiology) was founded, namely that each symptom had to
HISTORY OF DEJA VU
correspond to the dysfunction of a recognized mental faculty.28,29 By the time Emil Kraepelin published his classic articles on the paramnesias--which he called "false reminiscences"3°---the theme had already been debated by others in the literature, for example, by James Sully in a chapter of his book on illusions of memory.31 Indeed, since the time of St Augustine, and contemporarily since H. Charlton Bastian and H. Emminghaus,8 it had been suggested that such experiences encourage belief in metempsychosis (i.e., "transmigration of the soul") and reincarnation. 32,33 Terms such as phantasms of memory, sentiments of pre-existence, pseudo-reminiscences, paramnesias, fallacies of memory, and eventually d6j~ vu were successively used to refer to overlapping clinical phenomena. During the final years of the 19th century, and as more attention was paid to clinical detail, further qualifications ensued: for example, paramnesias were said to occur in clinical states such as insanity, confusion, and delirium, and also in dreaming, clear consciousness, and normality. They were said to be either fleeting or persistent, spontaneous, and vivid, or sometimes only recollected with the help of hypnosis. It was believed that the recalled experience could have taken place either within the life span of the individual or even before birth. This latter view may explain the interest of psychic researchers in the paramnesias. Such multiplicity of names and views reflects the staggered evolution of the notions of consciousness and memory. James Sully, for example, divided "false recollections" into (1) false events (when the recollected event had not, in fact, taken place), (2) formal distortions of real events, and (3) temporal dislocations of real events. This classification was, in fact, modeled on an old division of the disorders of perception (namely into hallucinations, illusions, and sensory distortions). 31 Influenced by Sander's report on Erinnerungstiiuschungen (where the great German alienist, still working in Berlin, reviewed a wide number of phenomena including that of"the doubles") 34 and by James Sully, Kraepelin focused on one of Sully's clinical groupings, namely false recollections or true hallucinations of memory. He called them "pseudo-reminiscences" and subdi-
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vided them into (1) simple, (2) "evoked," and (3) "identified.''3° The first group included spontaneous images that appear in the subject's mind already accompanied by a "feeling of recollection"; the second included real perceptions that evoke in the individual the feeling that he has experienced them before (what is now called d6j~ vu); and the third included perceptions that evoke the experience of being exact copies of earlier ones. Although it is not always possible to differentiate between types 2 and 3, Kraepelin's classification suggested an analogy between simple pseudo-reminiscences and delusions and evoked ones and illusions and hallucinations. Kraepelin reported 18 cases, some borrowed from contemporary psychiatrists such as von Gudden and Forel. THE REVUE PHILOSOPHIQUE DEBATE
Interest in the paramnesias peaked in the middle 1890s. This is well illustrated by a debate in the Revue Philosophique. (This journal was founded in 1876 by Ribot, who remained its editor until his death in 1916; it published seminal reports in the history of psychopathology.) Andr6 Lalande (a philosopher) started the exchanges with a report summarizing the views of Sully, Ribot, Kraepelin, and the American W.H. Burnham. 8 He then suggested that (1) the feeling of false recognition was "instantaneous" and "complete" (i.e., the subject did not say that the situation was similar, but that it was exactly the same), (2) the experience was often accompanied by a feeling of anxiety or apprehension, and (3) the subject often believed that he could predict what was to follow. Lalande believed the phenomenon was not necessarily "pathological" and that (regardless of education) it was experienced by approximately 30 percent of the population. 35 He listed various explanatory hypotheses, ruled out reincarnation, and opted for a version of the "double representation" view. L. Dugas followed with a report criticizing Lalande's but admitting that "he had no theory of his own. ''36 He believed that the concept of false memory had to be distinguished from the "impression of d6jfi vu." This latter usage actually predates Arnaud's (see below). Dugas indicated that the term d6jfi vu had first been used by Verlaine (1844-1896) in his poem KalOido-
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scope, and reported that an acquaintance of his, who also experienced the symptom, had told him that Loti (the pen name of Julien Viaud, 1850-1923) described a similar experience on seeing the sea for the first time (to be found in Loti's Roman d'un Enfant). Dugas believed that d6jh vu was more common among young people (between ages 20 and 30) and agreed with Lalande that it was not necessarily pathological (because those reporting it often were balanced and intelligent people). Nonetheless, he suggested that it might reflect an hereditary taint. Dugas differentiated between false memories with and without a feeling of premonition (pressentiment). The former, which he called simple or incomplete, he explained as resulting from two perceptions separated in time by a short period or "absence"; and to explain the intensity of the first perception he considered it an "apperception." This concept, popular at the time, was defined as that part of attention that involved interaction between the presentation of the object attended to, the total preceding conscious content, and the preformed mental dispositions. It had been introduced by Leibnitz and developed by Kant and Herbart. 37 Dugas rejected Lalande's view that telepathy was at all involved in d6jfi vu, and suggested that it might be a special case of "double personality." DOdoublement de la personnalit~ was a popular notion in late 19th-century France: then, as now, it helped to explain clinical situations in which the subject presented contradictory forms of behavior. 38 The next to participate in the debate was Jacques Le Lorrain, who believed that Lalande's diagnostic criteria required tightening, and predicted that if this was accomplished, the phenomenon would become rare. 39 Next was Paul Lapie proposing a "coincidence" theory, according to which the imagination of man created situations that were then deposited as memories and that, on occasion, coincided with real-life perceptions. 4° Finally, the fray was joined by van Biervliet, 41,42who supported the double-representation view, and by the Italian Vignoli, 43who proposed a threefold explanation for d6j~tvu that included dream work, the speed of psychological processes, and disordered imagination. The Revue Philosophique debate was not satisfactorily resolved. However, it showed the
G.E. BERRIOS
difficulties involved in translating a sui generis experience into either psychological or neurophysiological discourse. In the event, those involved in the debate had to invent a form of inchoate "cognitive psychology. ''44 THE DEBATE AT THE SOCIETE
MEDICO-PSYCHOLOGIQUE However, the earliest clinical usage of the term d6jh vu in a fully modern sense remains unclear. This writer would suggest that it tentatively occurred in 1894 in articles written by Dugas, 36,45 and then definitely in 1896 at the meeting of the Socidt~ M~dico-Psychologique (Paris, France, February 24, 1896). In this historical session, Arnaud stated: "I believe that it would be better to abandon the words false memory and paramnesia that have the double inconvenient of being vague and inexact as the phenomenon in question may not be associated with memory at all. So to keep things clear and make no theoretical assumptions, I suggest illusion of d~jgz vu ...,,46 (my italics). Arnaud then chronicled the history of the concept, mentioning writers such as Wigan, Maudsley, Sully, Jensen, Sander, Pick, Anjel, Forel, Kraepelin, Ribot, Lalande, Dugas, and Sollier. He attacked the prevalent view that the phenomenon was "common in the normal": "It is likely that the frequency of the illusion of d6jfi vu has been exaggerated for it has been confused with analogous states such as obscure memories, vague and remote recollections, etc. The true d6jh vu has two central features: its intensity, which often borders on conviction, and the feeling of an identity between the subjective experience and that assumed to be recollected . . . " (p. 456) 46 (my italics). Arnaud distinguished a mild form and a severe form of the disorder, the latter being almost delusional in nature and mostly pathological. Then Arnaud reported the case of Louis, a 34-year-old graduate from Saint Cyr (the French military academy) who had a family history of psychiatric illness (mother was said to be "nervous") and had experienced d6jh vu as a child. After developing cerebral malaria in Tonkin, he returned to France in 1891, when he was found to be suffering from anterograde and retrograde amnesia. He improved after 7 months, but by January 1893 he began to report d6jfi vu experi-
HISTORY OF DI~J,&, VU
ences: for example, he claimed he could recognize newspaper articles that he claimed he "had written" himself. At the marriage of his brother, he insisted that he had attended the same ceremony a year before. After failing in his attempt to marry (through opposition from the bride's parents), he became aggressive and developed ideas of persecution and fears that his headaches were being caused by drugs given him. When receiving hydrotherapy, he had the feeling that he had visited the same establishment the year before. In July 1894, he was admitted to the Hospital of Vanves, where he "recognized" places, the staff, and even their words and gestures. On meeting Dr. Arnaud, he said: "You know me doctor. You also welcomed me last year, at the same time of the day, and in this same room. You asked me the same questions, and I gave you the same answers" (p. 458), 46 and he said the same to the great Jules Falret (then head of the establishment). At no time did the patient exhibit hallucinations; he kept insisting that his current existence was a repetition of the previous year's, and believed he could recognize great public events that occurred in France between 1894 and 1895 (such as the election of F61ix Faure and the death of Pasteur). Retrograde and anterograde memory defect remained present throughout. Arnaud asked pointed questions about the nature and duration of the phenomenon and about the interval between the "original perception" and the actual experience of d6jh vu. He criticized available theories such as the double brain, metempsychosis, telepathy, delayed perception, parallel hallucination, and successive perceptions of the same event separated by a moment of distraction. He concluded that d6j~ vu was a current experience projected onto the past. During the ensuing debate, Pierre Janet claimed that d6jh vu was a perceptual rather than a memory disorder, and Paul Garnier defended the opposite view. BERNARD-LEROY AND THE BEGINNING OF EMPIRICAL ANALYSIS
The final stage in the 19th-century history of d6j~ vu is marked by Bernard-Leroy's surveyJ 6 This researcher believed that because the phenomenon was subjective and there were marked interindividual differences, single-case report-
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ing was an inappropriate method of study. He conducted a survey based on a 36-question instrument that was widely circularized (with the help of the Revue of Hypnotisme and the
Proceedings of the Medico-Legal Society of New York). The instrument included complex questions, such as: "Have you ever experienced the feeling of so-called 'false recognition' alluded to by Dickens in the following passage... ?" Or question 15: "If you have experienced this, were you under the influence of alcohol, opium, morphine, ether, chloroform (please specify the dose)?" Or question 35: "Do you suffer from attacks, obsessions, phobias, panics, absences, convulsive tics or other neurological disorders?" It is no wonder, therefore, that respondents were only recruited from the educated classes (e.g., college students, philosophers, priests, medical doctors, psychologists, and writers) and included great men such as Paul Adam, Emile Zola, Paul Borget, Fernand Gregh, Jules Lemaitre, and E. Boirac. Leroy received 67 replies, but based his report on only 49, to which he added 38 cases culled from the literature. This method of data collection was relatively new at the time and is likely to have been inspired by the "International Census of Waking Hallucinations in the Sane. ''47 The idea had been first suggested at the International Congress of Psychology held in Paris in 1889. The ensuing survey, completed in 1892, was followed by another conducted by the Cambridge Society for Psychic Research. 48 Leroy concluded that heterogeneous phenomena were involved and that no one hypothesis could account for them all. THE AFTERMATH
Early in the 20th century, the Dutch psychologist Gerardus Hymans conducted two prospective surveys improving on Leroy's investigations. 3 Since then, little new had been said about ddj~ vu until studies were reported by Sno. In 1931, Berndt-Larsson suggested, once again that a normal form and a pathological form of d6j~ vu should be distinguished. The former type, which was transient and caused little emotional upheaval, resulted from a disturbance of perception akin to illusion; the latter,
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persistent and leading to perplexity and cognitive disorganization, constituted a veritable delusional disorder. 49 D6jh vu was thus considered analogous to the so-called misidentification syndromes (e.g., intermetamorphosis 5° and Fr6goli syndrome 51,52) in that both entailed delusional misrecognitions: in d6jh vu, of situations, in the others, of people. 53 Likewise, the jamais vu phenomenon was matched with the Capgras syndrome 54 in that both seemed to result from a pathological change in a putative feeling of "familiarity.''55
D6jh vu is nowadays rarely mentioned in studies on the experimental psychology of memory. 56-59Neuropsychiatric textbooks call it a "feeling" or an "illusion" and give no guidance as to what its relationship is to memory function. 6° Some French researchers have treated d6j~ vu as a disorder of perception61; others, as a "paroxysmic alteration of consciousness"62; and yet others, as in the case of Penfield, called it the "illusion of familiarity" and regard it as associated with the temporal lobe. 63 The debate continues.
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36. Dugas L. Observations sur la Fausse M6moire. Rev Philosoph 1894;37:34-45. 37. Lange K. Apperception. Boston, MA: Health, 1900. 38. Merskey H. The manufacture of personalities. The production of multiple personality disorder. Br J Psychiatry 1992;160:327-340. 39. Le Lorrain J. A propos de la paramn6sie. Rev Philosoph 1894;37:208-210. 40. Lapie P. Note sur la Paramn6sie. Rev Philosoph 1894;37:351-352. 41. van Biervliet JJ. Observations et documents sur les paramn6sies. Rev Philosoph 1894;38:47-49. 42. van Biervliet JJ. La M6moire. Paris, France: Doin, 1902:276-304. 43. Soury J. Sulla Paramnesia o false memoria. Nota del prof Tito Vignoli. Rev Philosoph 1894;38:50-51. 44. Adarraga P. E1 marco general de la psicologia cognitiva. In: CastiUa del Pino C, Ruiz-Vargas JM (eds): Aspectos cognitivos de la esquizofrenia. Madrid, Spain: Trotta, 1991:35-56. 45. Dugas L. L'Impression de 'l'enti6rement noveau' et celia de 'd6jh vu.' Rev Philosoph 1894;38:40-46. 46. Arnaud M. Un cas d'illusion de 'd6ja vu' ou de 'false memory.' Ann Med Psychol (Paris), 1896;54:455-471. 47. Parish E. Hallucinations and Illusions. London, UK: Walter Scott, 1897. 48. Gurney E, Myers FWH, Podmore E. Phantasms of the Living. Vol. 2. London, UK: Trubner, 1896. 49. Berndt-Larsson H. 0ber das D6jh vu und andere T/iuschungen des Bekanntheitsgefiihls. Z Gesamte Neurol Psychiatr 1931;133:521-539.
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50. Bick PA. The syndrome of intermetamorphosis. In: Christodoulou GN (ed): The Misidentification syndromes. Basel, Switzerland: Karger, 1986:131-135. 51. Christodoulou GN. Delusional hyper-identification of the Fr6goli type. Acta Psychiatr Scand 1976;54:305-314. 52. Pauw KW. Fr6goli syndrome after cerebral infarction. J Nerv Ment Dis 1987;175:433-438. 53. Markov~i IS, Berrios GE. The delusional misidentification syndromes. Psychopathology 1994;27:136-143. 54. Derombies M. L'illusion de sosies. Paris, France: Th~se de M6dicine, 1935. 55. Critchley EMR. The neurology of familiarity. Behav Neurol 1989;2:195-200. 56. Squires L. Memory and the Brain. Oxford, UK: Oxford University Press, 1987. 57. Parkin AJ. Memory and Amnesia. Oxford, UK: Blackwell, 1987. 58. Mayes AR. Human Organic Memory Disorders. Cambridge, UK: Cambridge University Press, 1988. 59. McCarthy RA, Warrington EK. Cognitive Neuropsychology. San Diego, CA: Academic, 1990. 60. Lishman WA. Organic Psychiatry. Oxford, UK: Blackwell, 1987. 61. H6caen H, Albert ML. Human Neuropsychology. New York, NY: Wiley 1978:155. 62. Paillas JE, Subirana A. S6m6iologie Neuro-Psychiatrique. Rev Oto Neuro Ophtalmol 1950;22:123-218. 63. Mullan S, Penfield W. Illusions of comparative interpretation and emotion. Arch Neurol Psychiatry 1959;81:269284.